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Plan participants less satisfied

For the past 20 years, Sanofi Canada is conducting a survey on the satisfaction of participants in a group plan. Year-to-year, their satisfaction decreases.

Danny Peak, manager, national private sector, at Sanofi Canada, has presented the highlights of the most recent survey at the Conference of the insurance and the investment. A major finding emerges from this, ” he said.

“The participants say their plan meets their needs. However, they are less likely to say they are extremely or well satisfied, ” said Mr. Peak. By 2017, 53 % of the participants responded thus, compared to 73 % in 1999. Quebec comes up with a lower score, at 48 %.

In regards to the quality of plans, 48 % describe it as being excellent or very good, compared to 59 % in 2006. Quebec is in the average, to 47% for the quality evaluation.

Among plan sponsors, 62 % of them believe that their diet is excellent or very good. “There are still 53 % of people who have a very good opinion of their diet, and 39 % that the plan responds well to their needs. However, we note an important trend and we must watch this carefully, ” said Mr. Peak.

Satisfaction is greater when one likes his job

He noted that employees who are satisfied with their job are much more likely to have a positive opinion about their health care plan. This level of satisfaction improves when tools for health promotion are offered. Or, again, when members are satisfied with their job.

The participants seemed to appreciate more the coverage of costs of routine, ” said Mr. Peak. Sponsors of plans differ in opinion. They seem to wish that the members give more value to the cost of unexpected, ” he stressed.

Some 68 % of the participants believe that their employer is more likely to control costs that provide the best benefits for the health. It is up compared to the year 2000, where 51 % of the participants expressed such a feeling.

About 29% of plan sponsors say they establish a ceiling on annual or lifetime benefit on their health insurance plan. The advisory board of Sanofi Canada considers that the capping plan has potential effects on the medication, productivity, and morale, ” says Mr. Peak, citing Art Babcok, vice-president ofAon Hewitt.

The culture of well-being is not in progress

In general, the results show that in the work environments that promote the health and well-being, the employees say they are much more satisfied with their work and more positive about health care plans. This culture of well-being, positive as it may be, is not in progress, according to the survey data. And the willingness to invest more in the future, is also in decline. “These data should challenge us,” said Mr Peak.

He reports another statistic troubling : employers significantly underestimate the presence of chronic diseases in their workforce. Some 57 % of the participants claim to have at least one chronic disease, then that plan sponsors estimate that 32 % of their employees suffer from a chronic disease or a health problem.

Seven participants out of ten say they are receptive to receiving, by the insurers, the health information targeted according to the data of their claims. It is also found 64% of employers who wish to include this element in the design of the plan.

Mr. Peak believes that the front-line advisors must help employers to recognize that ” organizational health, organizational health and the physical health of employees and provide a better financial health “. The advisors may lack tools to do so, and the industry needs to improve in this regard, ” he said.

The efforts of the industry

Assistant Vice president of public and governmental affairs at thecanadian Association of insurance companies of persons, Québec division (CLHIA Quebec), Suzie Pellerin pointed out that 80 % of Canadians are covered by group insurance, compared with 67 % 10 years ago. “There is a widespread media coverage and important that is available to all Canadians,” she said.

We found some 25 million of Canadians who are covered in terms of supplementary health insurance. The premiums paid total $ 27.5 billion ($G$), of which 90 % are obtained through a group plan. By adding the premiums for disability and other coverage, the premiums are approaching 41 G$, ” she continues. On an average of five years, approximately 86 % of premiums are paid in benefits.

Ms Pellerin has also echoed the rise of the cost of the plans, mainly fuelled by the drugs more expensive. It is predicted that by 2022, 40 % of spending on prescription drugs will be related to specialty drugs, compared to 22 % in 2012 and 30 % in 2016.

3 major sources of pressure

The bill of paramedical care increased by an average of 9 % per year since 2009. This is one of the main segments where fraud is observed, adds Ms. Pellerin. “Fraudsters are extremely creative. Before, we had a received a massage therapy, you changed the amount. Now, techniques are more refined, ” she says.

She gives as example the case of a professional who was using his trade of prosthetics as a tool for the sale of luxurious products to its customers. It refilait the bill to the insurers.

For Danny Baker, CEO of Segic, a company launched in may 2015, and one of the few to aim for the market of self-insurance and self-management, there are three major sources of pressure that threaten the sustainability of collective schemes and the business model of insurers. The first is the rising costs of health care.

He cites a study by CIRANO, which indicates that in order to maintain the budgets equivalents devoted to health, the government of Quebec will have to increase by 60 % its revenues coming from taxation by 2030. According to Mr. Baker, the treatment of chronic disease represents a large part of this increase.

Second source of pressure : the technology has always been an agent of change. The insurance can not be an exception. It must make a profit, ” he said.

The third way of putting pressure on the business model affects the new generations of 35 years and less and less concerned about current design plans that were designed in the 1960s. They are more concerned with the prevention, connectivity and online trade-in, as well as by the collaborative economy.. The plan managers have to adapt their offer, ” said Mr. Baker.

“Our contention, as a young company in the field, is that it is necessary to separate the insurance and the health. We need insurance. But the health, it is one of the elements for the well-being, absenteeism, stress in the job, ” he says.

He adds that it is necessary to re-enter the health within organizations. “It takes the collective insurance. It takes us also a program of group health, ” insists Mr. Baker.

Pass from seller to professional

Pierre Piché, director general ofQSA Consultant, was the first president of the Regroupement des consultants en benefits of Quebec (RCASQ) in 1997. Already at the time, he called for the representative to pass on the role of seller of products to that of a professional benefits.

“The presence of group insurance plans in the workplace is increasingly necessary,” he said. The plan is part of the benefits offered by the company, and even becomes an essential element of negotiation of working conditions, he adds.

The business model changed quite a bit, but not fast enough, ” he says. “We, the specialists of the insurance collective, we have not been able to evolve our profession. We limit our interventions to the sale of insurance products to pay a fee imminent. And we negotiate the premium, ” he said.

By improving their offer, the perceptions of customers with respect to group plans will rise toward the positive side, he says. “The quality group insurance products will also be improved. Insurers never remain insensitive to the movements of the insured, ” said Mr. Piché.